The Caesarean experience 

How good is the approach to women who have a caesarean to birth their babies ? Do all NHS trusts routinely give the same care to each woman and newborn or is it tailored to each individual ? 

I am passionate that the caesarean procedure is also a positive uplifting experience for the woman her partner and their newborn . 

I get upset when I hear stories from different midwives at various NHS Trusts that skin to skin contact at Caesarean section isn’t routine or perhaps not discussed antenatally . From today I’m championing that skin to skin contact should be a priority for ALL WOMEN AND BABIES in the operating theatre and I’m doing this for several groups of women including those who

1. Were totally unaware that  skin to skin contact at caesarean was possible . 

2. Hear stories of women who held their baby skin to skin perioperatively when own their babies are older and they missed out on it which leaves them feeling robbed and upset. 

3. See photographs of babies in skin to skin contact during caesarean and they didn’t know they could take photographs 

4. Realised that skin to skin is possible but they weren’t given the choice 

5. Feel sad that the baby’s other parent wasn’t encouraged to hold their baby skin to skin during the caesarean operation . 

And this blog post is also for any woman who has an assisted birth in an operating theatre – I’m going to help you challenge NHS systems and change the birth discrimination between normal birth and birth in theatre . 

Why am I calling this BIRTH DISCRIMINATION

In my opinion every woman who gives birth should have the chance to hold her newborn in skin to skin contact even if only for a few minutes perhaps because the newborn requires transfer to neonatal unit or the woman feels unwell peri-operatively . 

Women who have a normal vaginal birth are more likely to hold their newborn for longer and separation from their newborns during the ‘golden skin to skin  hour’ will be less likely to happen. However, if a child is born in the operating theatre separation will occur within half an hour because of risk assessments meaning that the baby is moved as well as that within some NHS Trusts phones or cameras are not allowed in theatre and here are my thoughts on this matter which is close to my heart . 
We can no longer ignore the birth discrimination that exists between normal birth – where the woman has prolonged uninterrupted skin to skin contact – and assisted birth . It’s the role of everyone who is involved with birth in the operating theatre to work together to reduce and / or eliminate this birth discrimination.  I’m talking about midwives , anaesthetists , paediatricians , obstetricians , neonatal nurses , ODPs , maternity support workers coming together to form multi-disciplinary teams to plan how skin to skin contact length and opportunity can me maximised and separation minimised . 

We are all aware that skin to skin contact is beneficial in numerous evidence based ways (just go onto google scholar and search “skin to skin contact at birth”  to both mother and baby. It is NOW time to take action and assess each woman and baby individually instead of adhering to a ‘one size fits all’ approach . Of course there are women who may have to have a general anaesthetic – so consider this from the baby’s point of view – and work out a way that the other parent might be able to provide skin to skin for the newborn . 

We are in 2017 and now is the time to make change happen – talk about this to your MSLCs , the labour ward forum meetings , MDT meetings and be pro-active – together we can all make a difference 

Thank you for reading – jenny ❤️

To be continued ….. 

Image

The baby’s here – NOW what ? 

You have just given birth – it’s your first child and I’m not sure whether you had a Caesarean birth or a forceps birth or your newborn arrived in a birth pool . What really matters is that you receive consistent, evidence based advice from the health care professionals you come into contact with and positive support from your family and friends –  you’ll be exhausted and must try not to rush yourself back to normality too soon – try installing a mindfulness app into your phone and ALLOW your friends to do your shopping/ ironing / take some laundry off your hands . Don’t be too proud to admit tiredness , worry and emotions . 

Take a good look at the #MatExp website and join the Facebook page for access to health care professionals , peer supporters and other new parents – ask questions and interact with others so you can gain knowledge and know when to recognise that things might not be quite right . 

The biggest thing to hit you right between the eyes is the responsibility of parenthood including how to cope with reduced amounts of sleep , hormone imbalances , post birth bleeding , the increase in laundry (which seems so huge for such a tiny person and more than double with twins !) and how to deal with unexpected visitors who always seem to turn up when it’s nap time . Who said babies sleep all day ? 

Well here is my blog to try and help you to make some sense of your early days 

Humans have been parenting for thousands of years , babies communicate through crying and facial expressions and you have an inbuilt mechanism that is made to help you to nurture your young . Keep on keeping on with skin to skin contact as new evidence shows that mothers who give their babies plenty of skin to skin contact are more responsive parents . Picking up your baby each time he or she cries is not spoiling the child – HERE IS A LINK TO EXPLAIN WHY A BABY DEVELOPS BETTER WHEN HE SHE IS PICKED UP MORE. UNICEF have lots of evidence based resources and this is a wonderful PDF document UNICEF leaflet on building a happier baby – we are in fact building humans – kindness and compassion towards our young helps the brain take in more information and this in turn reinforces to the child that kindness matters , so he she grows up to be more aware of her / his own feelings and the feelings of others . 

Trying to sift thought all the postnatal advice leaflets and decide which friend / in-law , relative has the best advice on getting your baby to sleep is just overwhelming . 

First of all don’t push yourself too much to get through one week unscathed – it’s better and more realistic to try and get through a couple of hours feeling positive about what you’ve achieved. Take regular pain relief to help your mobility and well-being and don’t scrimp on rest – did you know that skin to skin contact reduces pain in mother AND newborn? 

Let’s move onto  the key things your baby needs to grow and develop as well as feeling nurtured 
1.Love which includes feeling nurtured and receiving kindness . Love also means giving yourself kindness and listening to your own mind and body .A baby knows from the tone of your voice whether you are happy and feeling loving towards it – so try hard to keep love in your heart . If you are not feeling this way seek some advice – your love might come later , or you may just be exhausted . If you feel unwell , emotionally drained , or just flat talk to your midwife and let her know – she’s not their to judge you but to signpost you to the correct services available . Do not berate yourself if you are suffering from post-natal depression and/or anxiety – we live in a modern world that doesn’t seem to support the value of resting , being still and calmness – digital advances seem to put more and more pressure on us humans to try and prove we are beyond human – the modern woman  is the equivalent of a plate spinner – don’t take on too many committtments – try practising some self-care and slow down – your body and mind  need rest and stillness as much as they need love , nourishment , kindness and compassion . Here is a wonderful blog about a mother who realised she was shouting too much and was too distracted by others things that led to a kind of moodiness towards her children CLICK HERE TO READ 

2. Feeding your newborn is not just about giving a baby milk – the way a baby is held during a feed , the way a mother talks to her newborn and keeping the number of people who give the feed to a minimum has a more positive impact on the baby’s developing brain. I hear many women say “I’m not going to breastfeed as my family want to help me with bottle feeding”. 

The first feed of colostrum is a crucial power food to help the newborn to  begin its journey of life. Obesity is a now a public health problem and it’s time to address the low numbers of babies that are breastfed – if a baby maintains skin to skin contact with its mother at birth for over two hours – there is an increase in breastfeeding success – we are talking about not moving baby at all for any reasons including during Caesarean section, perineal sutures, returning to theatre for any reason and always considering SkinToSkin contact.

The postnatal period should include regular prolonged episodes of skin to skin contact to soothe babies , maintain the all important bond with the parents and help milk production . Breastfeeding helps babies to …

1.Recover from birth 

2. Feel safe and nurtured 

3.protect the immature gut and bowel by receiving immunity from the mother via her bespoke breast milk . 

4.feel comforted – because a baby that breastfeeds must be held close and that situation is very comforting to a newborn 

The one to “oneness” that #SkinToSkin and breastfeeding gives a newborn is actually is not something that can be replicated in another form – it’s a one off that’s been passed down the centuries , a primitive response that goes back in time to when we lived in caves and our mothers held us close away from other predators . It’s much more grounding for a newborn to feel close to less people and as it gets older you can widen the circle very gradually. SkinToSkin during breastfeeding gives the baby a strong sense of belonging . There are also responsive bottle feeding methods . The SLING LIBRARY offers information about slings across the U.K. click HERE for the website and slings give freedom to do other things whilst carrying your newborn hands free : ) 

A baby should never be fed without being held – being held during a feed is soothing and promotes a sense of safety & emotional security . Talking , singing and smiling during feeds with intense eye to eye contact is of paramount importance for a newborn’s brain development .  

3. Warmth – so important that a baby feels comfortably warm not overheated and is unable to move down under its blankets – the baby’s position should always always be on the back . The “Back to sleep ” campaign was started by Anne Diamond . Click HERE for more information about how Ann spread the word after the death of her beloved son Sebastian died from Cot death at only four months of age. It is now advised that babies are put on their BACKS to sleep and also that they sleep in their parent/s room until after the age of 6 months old . 

The media in general doesn’t give out evidence based advice and seems to berate parents who choose to co-sleep . Co-sleeping is something that must be discussed and Durham University has a sleep laboratory which has looked at how and why mothers co-sleep with their offspring – Click here for evidence and sound advice about Co-sleeping. Professor Helen Ball has filmed parents in sleep situations to help us to learn what’s safe and what’s not . The problem with the media is that by criticising co-sleeping they are actually promoting sofa sharing and feeding which is a dangerous practice . Click  HERE for an honest upfront article by the fabulous Milli Hill parenting and birth guru about co-sleeping. 

Your house is the environment your child will see as their safe place – so don’t try to change it too much as a temporary measure – keep it as your home to welcome your newborn . You can adapt areas as your child grows and develops . Try keeping changing equipment in two different areas so you don’t have to go to one room all the time . 

Let your bedroom be your safe haven where you can escape with your baby to feed , rest and avoid the “popper inners” the visitors who simply turn up unannounced . 

Try not to plan too many trips out too soon or those that require a long drive – as mothers soon get tired in the initial few months . A change of scenery is good though and can be a welcome escape from the house . Don’t be talked into your newborn going for a sleepover too soon – when it does happen you may  find yourself unable to relax until you hold your baby again . The other parent can walk the baby whilst mum rests (that doesn’t mean cleaning etc!!) and it’s a good thing to try and learn how to sleep in the day – even though it’s against everything you are accustomed to as a new parent you are  in fact a shift worker so must try and care for yourself or you will become burnt out , exhausted and this could lead to anxiety and / or depression and this applies to BOTH parents.

What about Dads ? Well I love social media and I found this great tool called TheDadPad which is £8.75 supported by the NHS and basically a set of information pads that are wipe clean and give good advice on caring for your newborn as a new dad . 

Same sex couples also need support – just because a baby has two mummies doesn’t mean that life is all hunky dory – all parents need to know they are doing ok . 

Isolation , poverty and lack of friends can affect parenting- but believe me , not having the latest pram or changing bag does not make you less of a parent . Health visitors are skilled at knowing where there is safe second hand baby equipment which is a lot less expensive – always google the product so that any warnings regarding safety are found before you commit yourselves to it – second hand equipment must come with full instructions and explanations as well as safety recommendations on how NOT to use . 

If you feel unwell at anytime in the first 6-8 your lifeline contact is with your local delivery suite . Here waiting isn’t long and you get to talk to a midwife one to one and discuss your symptoms . The problem with going to A & E is that they aren’t designed for mothers and/or newborns and they hold a lot of unwell people . If you have any pains or swellings in your legs / chest pain / fast heart beat / your bleeding heavily / your bleeding has an odour / you are hot and cold please do not delay as any of these symptoms could be a venous thrombosis or signs of sepsis – getting to the Women’s unit faster means quicker diagnosis and treatment . Read about sepsis in more detail HERE on the Sepsis Trust website where you can read about symptoms of sepsis clear concise information. 

Refer to your postnatal notes for yourself and your baby for clear advice on minor postnatal symptoms as well as why you may feel unwell – but more importantly talk to health care workers who will give you consistent advice about coping with a newborn . Don’t be fooled by perfect photos – underneath it all most new parents struggle with their lack of sleep . 

Try to get out during the day even if it’s just visiting a family member or friend at a house . Being isolated is not a good feeling and can be detrimental not only to your own mental and physical health but also the newborn’s ability to socially connect and brain growth . 

In this modern world it’s important to switch off digital devices and talk to babies – if you find this hard reading a book or singing songs is a positive way of communicating. 
Keep a mini journal of your days when you felt tired out and see if you are feeling less or more tired as the weeks go by . If you are feeling more tired look at what kind of activity you missed out on OR overdid . Did you eat well ? Rest ? See friends ? Spend any time in skin to skin with your newborn ? 

I’ve written this blog so you can try to find information that’s sensible and not prescriptive and I hope you find it useful . If it’s any consolation I was totally exhausted for months and I developed post-natal depression which wasn’t really talked about much in the 80s. I even left my daughter in her pram outside the local post office , not realising until I had say down with a well deserved cup of tea – needless to say I ran back for her and never did that again !! So you see if I can admit to that , what do you think other new mum’s have got up to ? 

Becoming a parent is lovely but it is not as perfect as it’s made out to be. Best beginnings have launched a series of films called “Out of the blue” and CLICKHERE for a link to a film on how new mothers can learn to look after themselves . If parents take good care of themselves they will be more likely to care for their children well and be positive role models . 

I hope my blog inspires you all on the start of your journey as parents and I wish you and your newborn love , kindness and understanding ❤️

With woman midwifery 

❤️Before I start I’d like to thank Soo Downe for using this photo of me with my pinards in her slides during this years EMA ❤️ &  thanks to Jacque Gerrard RCM for letting me know. 

Hello , are you a midwife ? Have you ever heard or said any of the following sentences ? 

“I’m coming in the office for a few minutes , they don’t want me in there all the time” 

“I’ll leave you in peace for a while – you don’t need me here all the time” 

“I’m giving them some time to themselves whilst she’s in the early stages” 

There is evidence and research to prove unanimously that women who have continuous one to one care have less pain relief , more incidence of normal birth , less perineal trauma and feel more positive about their birth process . As midwives there’s always information to share and explain that the woman may not know about . I also view my role as a guardian to the partner making sure he or she feels involved and free to ask questions . So the next time you hear yourself or a colleague say “I’m leaving the couple I’m caring for as they don’t need me in their birth room all the time” just remember leaving them  isn’t evidence based practice – staying with them totally is 

Resources on continuity 

http://onlinelibrary.wiley.com/store/10.1002/14651858.CD004667.pub5/asset/CD004667.pdf?v=1&t=iwl6t8eo&s=72d734e7de6a3665a8d183e2d5df1492e37dc2ec

http://www.sciencedirect.com/science/article/pii/S0140673616314726

http://www.sciencedirect.com/science/article/pii/S0266613816300572 

#LeadToAdd 

LeadToAdd click HERE to learn more is the latest NHS England campaign # is #LeadToAdd. As a Caremaker I will be linking this on Twitter with my work on #skinToskin , #futuremidwives and #couragebutter to inspire others to see themselves as leaders regardless of their role . Patients, women, families and non-clinical staff are also leaders .  
I feel this will inspire/activate different meanings to different people

Here are some of my thoughts around it

What does to lead mean ? 
To take charge , to be at the front , to inspire , to educate, to be diverse 
Leading is about being at the front and CONSTANTLY looking back to bring others with you

Leading is about being the first to begin something but not necessarily holding onto that but looking at how your actions impact on the way others fulfil their role. Leading is being a positive role model, leading is about looking inwards at your own behaviour and also looking outwards at the behaviour of others . 

In the NHS all staff need encouragement to recognise themselves as leaders and also to see that some behaviours do not embody leadership. We are all learning each day, so don’t stay still – question yourself and the way you speak to others . Ask a colleague to listen to you talking to patients and staff and to give you feedback -what could you change ? Integrate telephone conversations into drills training-  talk to your practice development team – think outside the box . 

Someone who leads others into poor practice is a poor leader but a leader non the less so be aware of your own commitment to pass the positive leadership baton . We are human and it’s ok to make mistakes , however we must learn, evolve and change .

The other day I had a car journey with Joan Pons Laplana (@ThebestJoan on twitter) and once again he made me think hard about how the 6Cs are integrated into practice . Joan said to me that as a health care professional all tasks and procedures must embody the 6Cs – even answering a telephone call. 
As a form of reflection I’d like you to read passage one and then passage two
Passage One 
Busy labour ward – phone ringing , midwife answered the phone – we will call the person making the call Tony and his partner who is having a baby is called Dolores. The midwives name will be Darcy . 
Midwife ( confident and cheery) ” hello labour ward , midwife speaking how can I help you?”
Tony (nervous voice) ” oh hi – err my partner thinks she’s in labour , it’s our first baby and we are a bit nervous . Could I ask you some questions , she’s here but having a contraction right now and then she feels sick for a few minutes after its gone. 
Midwife “oh right well I need to talk to her please and decide what’s happening’  
I’m not going to continue this but could the midwife change her approach ? Is this midwife you ? A colleague? This approach has been learnt from a peer
Passage Two 

Busy labour ward – phone ringing , midwife answered the phone – we will call the person making the call Tony and his partner who is having a baby is called Dolores. The midwives name will be Darcy . ….

Midwife ( confident and cheery) ” hello labour ward , my name is Darcy Jones I’m a midwife and how can I help you?”
Tony (nervous voice) ” oh hi Darcy – I’m Tony – err my partner Dolores thinks she’s in labour , it’s our first baby and we are a bit nervous . Could I ask you some questions , she’s here but having a contraction right now and then she feels sick for a few minutes after its gone. 
Midwife “ok well I would like to take some details first whilst Dolores has a contraction . Thank you so much for ringing us . How are you feeling ? This is your first baby ? How exciting for you both!” 
I’m not going to continue this but could the midwife change her approach In either scenario – which is the best one in your opinion ?  ? Is either of these scenarios you ? A colleague? This approach has been learnt from a peer. 
So you see two examples each one leaving the person contacting  the service with different emotions . 
Start your journey as a #LeadToAdd leader today  ❤️
Thank you for reading 
Love , Jenny ❤️

The natural caesarean / the gentle caesarean 

There’s a debate on Twitter this morning about the ‘natural caesarean’ as a term that promotes a positive experience of birth by caesarean. I don’t agree with the term and I think as health care professionals working in the area of birth we should ensure that every birth is a positive birth . Milli Hill started the The Positive Birth Movement  with this goal in mind (@birthpositive on Twitter ) 

Bearing this in mind I’d like to ask the following questions for you to consider and share with with your colleagues, family , friends , midwives and obstetricians . 
1. How many women who have an emergency caeserean and/or instrumental birth (forceps or ventouse) are given information in the antenatal period about the far reaching health and psychological benefits of skin to skin contact in this setting to both mother and baby ? 

2. Compare the above with how many women are given information about  skin to skin contact around normal birth ? 

3. Compare both to how many woman are informed that skin to skin is possible during manual removal of placenta and repair of any perineal trauma in the theatre setting ? 

4. Are women informed 

  • They can TELL midwives to defer the weighing of their newborn in order to enjoy the benefits of prolonged skin to skin contact 
  • That they should never be separated from their baby unless a clinical situation becomes apparent or they themselves choose not to have skin to skin contact despite being FULLY informed
  • That their baby could ‘self latch’ at the breast without any handling by staff and also correct its own acidosis and stabilise its own breathing because of skin to skin contact ? 
  • That skin to skin and early breastfeeding “Pronurturance ” is linked to a reduction in the incidence of  postpartum haemorrhage?  CLICK RIGHT HERE for the Pronurturance paper 
  • That if babies could talk they would choose skin to skin contact despite their birth environment 
  • That skin to skin contact is the building block for a persons social and psychological development 

The midwives and staff on social media who talk about caesarean are not promoters of it , they are giving women information about choice – so that if the operation (which is major surgery) does take place then these women are able to not only enjoy their birth experience but give their relationship with their baby the best possible start . 

I suppose it’s similar to the question “does having a teenage pregnancy strategy increase teenage pregnancy rates ?  (and I much prefer the term  “young women”to ‘teenage pregnancy’) 

Does having full information about your choices if you do go on to have a caeserean increase caesarean rates ? I don’t know the answer to either of these questions but I do know that the women I have assisted and sometimes fought for to have skin to skin contact with their newborns in different birth situations have all told me this 

 
-that they never realised the positive impact it had on them as a successful mother

To me this is enough .   
Thank you for reading 

With love , Jenny ❤️

I am also promoting #MatExp as a platform which enables and encourages discussion between women, families and health care professionals . 

The Gentle Caesarean – Gentle with what ?

Last year I was lucky enough to work in a general theatre for a week . I met a wonderful general surgeon and watched him perform bowel surgery . I noticed immediately how gentle and kind he was with the internal tissues and how calm and respectful he was not only towards the patient and his body , but also the staff in the operating theatre. All the staff admired this surgeon – you know when you can just tell ?  

I asked the surgeon afterwards about his technique and he said this

 “I always respect the tissue Jenny- tissues , blood vessels  , muscle and skin are part  of our human make up and being gentle with them means I am showing tissue respect and respect to the patient who is a fellow human . Being a gentle surgeon takes longer but believe me the outcomes are better and I know that there is less trauma , post-op bleeding , infection, pain and therefore happier patients and staff .”

Currently there is a lot in the news and emerging research around “The Gentle caesarean” and I am looking at this from a different angle  (and for those who know me well I don’t do acceptance well – I like to ask things so that others unable to ask might think differently ) so I am questioning what this term “Gentle Caesarean” actually means . Does Gentle Caesarean mean just the moment of birth or should it be right from the decision or choice of the woman to have an operative birth through to arriving home ? 

So for all those who work in the field of midwifery , obstetrics , intra-operative care, surgery , pain management -I would like you to watch a caesarean from start to finish and ask yourself “was that a gentle caesarean from that the moment that the woman arrived in theatre ? Was there gentleness with the woman’s feelings and choices ? Did the obstetrician, scrub midwife and others maintain gentleness towards the internal tissues and the to the baby? Was the transfer to the bed from the operating theatre table gentle ? Was privacy and dignity maintained at all times? 

Just because we have always done something a certain way does not mean that “the way” is always the best . 

I hope I spark someone to change practice and make “The gentle caesarean” standard across the NHS because then it will spread  globally – we must question on a  daily basis what we do and why we do it .
Thank you for reading , please leave feedback and / or share this blog with your colleagues 
With love and midwifery kindness , 

❤️Jenny❤️
Addendum today I am thrilled that The Times journalist Katie Gibbons has written an article about skin to skin contact at Caesarean  CLICK HERE to access or being the rebel that I am here’s a photo 😁

 

Memories of skin to skin contact 

Those were the days weren’t they? Or were they ? 

This week I met up with a friend (pseudonym Niamh) who is a mother of four. She recounted to me each tender moment that each of her children was born . The last three were born by Caesarean section . “Did you hold them straightway?” I  asked .

Niamh replied “to be perfectly honest no – I held none of my children that were born by Caesarean section immediately in fact not for severel  hours ” Niamh then recounted to me the birth of her son – when he was about 6 hours old she had still not seen him properly and asked a midwife how he was doing – the midwife told her that he was fine but due to breathing problems he was in an incubator . SIX HOURS !! I want to add that no one had told her until she asked . 

If you are a midwife , an anaesthetist , an operating department practitioner or a theatre nurse. If you work in an operating theatre , or  if you teach those who do -I want you to think carefully about why we must all strive to keep mothers and babies together in the theatre setting . 

I know it’s becoming more common for skin to skin to happen and I realise that if it’s not happening that to fight the system and challenge separation is difficult but we must keep moving forwards  . The reason is simple – skin to skin makes babies happy and it makes mothers happy and feel like mothers . It reduces postnatal depression and admissions  to neonatal units , I’ve even seen it stabilise a mother’s parameters. There is new evidence emerging to show that in effect if Nimah had held her son straightaway he may not have been admitted to neonatal unit with breathing difficulties . 

Skin to skin is human nature – we must tell women why it’s important not just ask 

      “would you like skin to skin contact ?” 

We need to say

 “If you hold your baby immediately against your skin and WE will provide help and support . As a mother you can instantly reduce the chance of your baby producing  the stress hormone cortisol and this contact can and does have a positive nurturing effect that is invisible as it happening.

As health care professional we must practice evidence based medicine and skin to skin is evidence based . We are responsible for teaching why it matters – not just throwing it into a checklist, box ticking exercise . 

The ‘Niamh’ I am talking about is in her late 70s – her children ages range  from 38 to 48 years of age . Niamh recalls each birth , each separation  but even more than that she remembers her feelings of despair at wanting to see touch and smell her babies but feeling like she couldn’t ask . 

That to me puts it all into perspective .
If you’d like more evidence here is some of the latest publications 
Pronurturance 

http://www.sciencedirect.com/science/article/pii/S1871519215003558

Skin to skin at caesarean 

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003519.pub3/pdf/

http://onlinelibrary.wiley.com/doi/10.1111/mcn.12128/full 

I recommend you follow the following people and organisations so that you can converse  with those who are champions for skin to skin contact 

@JeniStevensS2S @CarolynHastie @HeartMummy @FWmaternitykhft @KathrynAshton1 @Natasha47 @Csectioninfocus @hannahdahlen @bloodtobaby @AAGBI 

Please take a look at my “skin to skin FB page”  for more resources 

https://www.facebook.com/Mother-Infant-contact-skin-to-skin-in-the-operating-theatre-setting-445225315630071/ 

Thank you for reading  #Keepgoing ❤️
With Love , Jenny ❤️